This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Wednesday, May 13, 2015

Here Are The Main Details Of The E-Health Area Of The Budget For 2015-16. Very, Very Interesting!

This is the detail.

Programme 7.1: eHealth

Programme Objectives

Redevelop and operate a national shared eHealth record system

The report from the Review of the Personally Controlled Electronic Health Record, released in May 2014, made recommendations aimed at improving the operation of the system and increasing use by healthcare providers and individuals. In 2015-16, the Government will work with stakeholders to implement key recommendations from the review including: usability improvements; renaming the system as My Health Record; revised incentives; and education and training for healthcare providers. The Government will also commence trials of new participation arrangements, including an opt-out system recommended by the review, to inform future strategies for increasing uptake and meaningful use of the My Health Record.

Provide national eHealth leadership

The Australian Government will continue to lead the national roll out of eHealth technology and services, and work with the States and Territories to support eHealth foundations, and finalise a national eHealth strategy. This strategy will identify the priorities for future Commonwealth and jurisdictional investment in eHealth.

In 2015-16, an Implementation Taskforce will be established to oversee and manage the transition of governance arrangements and eHealth operations from the National eHealth Transition Authority and the Department of Health to the Australian Commission for eHealth. This Commission will assume responsibility for the governance, operation and ongoing delivery of all eHealth across Australia, including the My Health Record from 1 July 2016.

In 2015-16, the Practice Incentives Programme (PIP) eHealth Incentive will be reviewed with the aim of encouraging general practices to contribute to and use the My Health Record system to improve clinical decision-making and the continuity of care for their patients.

Programme 7.1 is linked as follows:

·This Programme includes National Partnership payments for:

-Tasmanian electronic patient information sharing.

National Partnership payments are paid to State and Territory Governments by the Treasury as part of the Federal Financial Relations Framework. For Budget estimates relating to the National Partnership component of the programme, refer to Budget Paper No. 3 or Programme 1.9 of the Treasury’s Portfolio Budget Statements.

·The Department of Human Services (Services to the Community – Health Programme 1.2) to support operation of the My Health Record.

·The Department of Industry and Science (Business and Market Development – Programme 3.2) to expedite clinical trial reform in Australia.

Programme 7.1: Expenses

Table 7.2: Programme Expenses

2014-15 Estimated actual$'000

2015-16 Budget

$'000

2016-17 Forward Year 1$'000

2017-18 Forward Year 2 $'000

2018-19 Forward Year 3 $'000

Annual administered expenses

Ordinary annual services

135,221

135,981

129,963

120,944

5,062

Non cash expenses1

18,309

18,309

18,308

-

-

Programme support

23,127

20,829

10,515

10,577

10,830

Total Programme 7.1 expenses

176,657

175,119

158,786

131,521

15,892

1“Non cash expenses” relates to the depreciation of computer software.

Programme 7.1: Deliverables

Qualitative Deliverables for Programme 7.1

Redevelop and operate a national shared eHealth record system

Qualitative Deliverables

2015-16 Reference Point or Target

Good practice principles and methods are applied to the operation and support of the My Health Record system.

The My Health Record system operations and practices are regularly reviewed to improve performance and usability.

Trials of new participation arrangements are undertaken, including for an opt-out system.

Trials to commence in 2016.

Provide national eHealth leadership

Qualitative Deliverable

2015-16 Reference Point or Target

New eHealth governance arrangements are implemented, including establishment of the Australian Commission for eHealth.

12 comments:

"The Government will also commence trials of new participation arrangements, including an opt-out system recommended by the review, to inform future strategies for increasing uptake and meaningful use of the My Health Record."

I read this as saying that they have not yet decided to change to opt-out. The trial is to "inform future strategies".

Which means that I agree with David's observation: "The suggestion that this is all just a holding action to keep things ticking over while actually doing a new Strategy and working out what to do is looking better and better!".

It also makes sense in terms of the small amount of money that's been allocated to the PCEHR.

I suspect that they are really testing the water to see if opt-out will be accepted by the population at large. I don't fancy their chances.

So in rough terms, the government's role is "all care, but no responsibility"?

With an opt-in model, a citizen can choose to accept this and all the other risks because they believe there is some value in having this sort of health record, along with all the other health records that exist over which they have no control whatsoever.

With an opt-out model there will be no choice. And unless the legislation is changed, the government has no legal liability if they make errors creating or maintaining health records.

Or if incorrect data leads to bad medical decisions and bad outcomes.

Or if health professionals have to spend time cleaning up bad records.

When you look closely at the evidence Bernard is correct .... they are at the beginning of a whole new strategy to close NEHTA and shift to a new 'entity', tragically they are working it out as they go without clarity of thought or any depth of understanding as to what needs to be done, why, how and by whom. It's a bit like watching a squash ball flying from wall to wall.

"... tragically they are working it out as they go without clarity of thought or any depth of understanding as to what needs to be done, why, how and by whom."

Unfortunately, with things this complex, it is essential to make the right decisions in the right order. And by that I don't mean that you make decisions one by one. Quite often there are groups of decisions that should be taken together and there are some decisions that need to be made before others.

Proper decision making requires the understanding that Ian observes is missing. Otherwise it's rather like throwing mud at a brick wall and seeing what sticks. It's a laborious process, you don't get a very good result and there is a lot of waste.

There is also a good chance that many bad decisions have already been made, decisions that will be expensive and time consuming to put right.